Provider Demographics
NPI:1992918247
Name:RAMOS, WILFREDO JUAN (MD)
Entity type:Individual
Prefix:
First Name:WILFREDO
Middle Name:JUAN
Last Name:RAMOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229, DEL PARQUE STREET
Mailing Address - Street 2:APT 801, CONDOMINIO PARQUE CENTRAL
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00912
Mailing Address - Country:US
Mailing Address - Phone:787-793-5959
Mailing Address - Fax:787-775-0093
Practice Address - Street 1:229, DEL PARQUE STREET
Practice Address - Street 2:APT 801, CONDOMINIO PARQUE CENTRAL
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00912
Practice Address - Country:US
Practice Address - Phone:787-793-5959
Practice Address - Fax:787-775-0093
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8045174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist